Reimbursement Assistance

CMA’s Center for Economic Services (CES) is charged with providing one-on-one practice management assistance to physician members and their staff. Our goal is to empower physician practices by providing resources and guidance to improve the success of the practice. Assistance ranges from coaching and education to direct intervention with payors or regulators. CES also develops resources and tools to assist practices.

The center is staffed by practice management experts with a combined experience of over 125 years in medical practice operations. Over the past 11 years, CES successfully recouped more than $30 million from payors on behalf of our physician members. Access to CMA’s practice management experts is members-only benefit.

When do I call CMA?
CMA members can call on CMA’s practice management experts for free one-on-one help with contracting, billing, and payment problems. If you answer “yes” to any of the following questions, it might be time to call for help.

Are your claims not being paid in a timely manner or according to your contract?

Do you need assistance regarding the new law on payment and billing for out-of-network services (AB 72)?

Are you receiving untimely requests for refunds or is a payor recouping money without first notifying you in writing of a refund request?

Do you need assistance creating a business case as to why a payor should consider contracting/re-contracting with your practice?

Do you need help with Medicare-related issues?

Are your claims being denied after obtaining prior authorization?

Are you receiving unreasonable requests for medical records?

Do you need help identifying common practice mistakes costing you money?

Have you been presented with a managed care contract and you’re not sure if the terms are consistent with California law?

Have you done everything you can to resolve an issue with a payor, including appealing, and have been unsuccessful?

Call CMA’s reimbursement helpline today and we’ll arm you with the knowledge you need to identify and fight unfair payment practices. For more information on our tools and resources, visit our Practice Management page.